Accuracy of Fine Needle Aspiration Cytology of Solitary Thyroid Nodules in Tertiary versus Community Hospital

Abstract

Background: Fine needle aspiration cytology (FNAC) is considered as the gold standard diagnostic test for the diagnosis of solitary thyroidnodules (STN). Aim: To compare the accuracy of FNAC in diagnosis of thyroid nodules in Al Khor community hospital versus that of tertiary hospital (Hamad General Hospital) in Qatar. Methods: Retrospective, descriptive and comparative study of 320 patients of any age group and both sexes who have thyroid nodules and are subjected to surgical treatment [160 patients from Al Khor community hospital (group A) and 160 patients from Hamad General Hospital (group B)] during the period from May 2005 to Dec 2012. Each group was subdivided into free hand FNAC (done by physicians) and ultrasonography guided FNAC. All samples were prepared in the same histopathology laboratory and interpreted by the same histopathology team. Results: Free hand FNAC in group A and group B achieved a sensitivity of (10% vs. 50%), specificity of 93% in both groups, positive predictive value of (25% vs. 17%), negative predictive value of (82% vs. 98%), and a total accuracy of (82% vs. 94%) respectively, while US guided FNAC in group A and group B achieved a sensitivity of (10% vs. 86%), specificity of (98% vs. 94%), positive predictive value of (50% vs. 60%), negative predictive value of (86% vs. 98%), and a total accuracy of (85% vs. 97%) respectively. Conclusion: The overall accuracy of FNAC of STN in tertiary hospital was better than community hospital. More training is required for community hospital staff.